| NPI | 1578833760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A KENEFICK Director 860-575-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 007155) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |